Comparative Study Between Latarjet Procedure Versus Free Iliac Graft in the Management of Recurrent Shoulder Dislocation

Abstract

The most common form of shoulder dislocation is the recurrent anterior traumatic type. Latarjet and Eden Hybinette are the two competing techniques in reconstructing significant bone loss accompanying this type. The aim is to evaluate the functional results in the management of recurrent shoulder dislocation with bone loss by comparing Latarjet and Eden Hybinette techniques. A prospective, randomized controlled trial was performed on forty adult patients suffering from recurrent shoulder dislocations. Two groups (a total of forty patients; twenty iliac graft cases and twenty Latarjet controls) were performed in a randomized method. We compared the two groups; clinical evaluation was completed before surgery and at least 1 year postoperatively, by using the modified Rowe score which consists of pain level, stability, motion loss, and limitation of function. Satisfactory results included excellent and good results, while unsatisfactory results included fair and poor results. Adverse events were prospectively recorded. CT studies were performed to assess the radiographic result preoperatively, immediately-postoperatively, and at final follow-up visits. Both groups did not differ significantly in either the clinical or the radiological aspects (P > 0.05) except for more limited range of motion (ROM) (external and internal rotation) in the Latarjet group at the final follow-up (P < 0.05). One case in the Latarjet group had recurrent dislocation due to tramadol fits. Two cases in each group had anterior apprehension only. Donor-site sensory disturbances were reported in 10% of the iliac group patients. Computed tomography revealed a larger graft size in the iliac group. Both Latarjet and Eden Hybinette can be used as reconstructive surgeries in restoring critical bone loss accompanying shoulder dislocations; they did not show significant differences except for the more limited external and internal rotation motions in the Latarjet group.